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Altered heart rate dynamics associated with antipsychotic-induced subjective restlessness in patients with schizophrenia

Authors Kim J, Ann J, Lee J, Kim M, Han A

Received 19 May 2013

Accepted for publication 18 June 2013

Published 19 July 2013 Volume 2013:9 Pages 989—994

DOI https://doi.org/10.2147/NDT.S48701

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Jong-Hoon Kim,1,2 Jun-Hyung Ann,2 Jinyoung Lee,1 Mee-Hee Kim,1 Ah-Young Han1

1Department of Psychiatry, Gil Medical Center, 2Graduate School of Medicine, Gachon University, Incheon, South Korea

Background: Antipsychotic-induced subjective inner restlessness is one of the common and distressing adverse effects associated with antipsychotics; however, its underlying neurobiological basis is not well understood. We examined the relationship between antipsychotic-induced subjective inner restlessness and autonomic neurocardiac function.
Methods: Twenty-two schizophrenia patients with antipsychotic-induced subjective restlessness, 28 schizophrenia patients without antipsychotic-induced subjective restlessness, and 28 matched healthy control subjects were evaluated. Assessments of the linear and nonlinear complexity measures of heart rate dynamics were performed. Multivariate analysis of variance and correlation analysis were conducted.
Results: The mean interbeat (RR) interval value was significantly higher in control subjects than in patients with and without antipsychotic-induced subjective restlessness (P < 0.05). The low frequency/high frequency ratio was significantly higher in patients with antipsychotic-induced subjective restlessness than in control subjects and in patients without antipsychotic-induced subjective restlessness (P < 0.05), while the approximate entropy value was significantly lower in patients with antipsychotic-induced subjective restlessness than in control subjects and in patients without antipsychotic-induced subjective restlessness (P < 0.05). Correlation analyses controlling for psychotic symptom severity showed that the degree of antipsychotic-induced restlessness had a significant negative correlation with the value of approximate entropy (P < 0.05).
Conclusion: The results indicate that antipsychotic-induced subjective restlessness is associated with altered heart rate dynamics parameters, particularly the nonlinear complexity measure, suggesting that it might adversely affect autonomic neurocardiac integrity. Further prospective research is necessary to elucidate the precise interrelationships and causality.

Keywords: antipsychotics, subjective restlessness, heart rate dynamics

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